Staffers who just won't behave

Slow work, carelessness, tardiness, insubordination (horrors!).
Working with people who don't seem to want to work with you

By Judy Dewalt

"Sometimes it feels more like I'm working for my employees than vice versa," complained a Calgary rheumatologist recently at a practice management seminar. He had a point. Many of your colleagues feel that when it comes to running their practices, they're doing most of the heavy lifting. Though the feeling isn't uncommon � you do, after all, bring in all of the revenue � it could be a symptom of a practice that's being sabotaged by its employees. Here are some of the most common staff-related problems and what you can do to remedy them.

LATENESS
Everyone comes in late now and then for legitimate reasons � the babysitter failed to show up, the bus didn't come, the alarm didn't go off, they had a flat tire and so on and so forth. Any doctor who's been in practice for more than a year has heard them all.

A certain amount of tardiness is normal but what do you do when it becomes chronic. The essential thing, say practice consultants, is to nip it at the bud. An employee who's chronically late two or three times a week, week in and week out, quickly breeds resentment (and tardiness) among other employees � quite apart from the hit to productivity.

You'll find that lateness quickly spreads to other staffers. The sooner you take control the better. Take the employee aside and ask if there's a legitimate reason for the lateness. Sometimes there is. A Brandon, MB physician discovered his receptionist was coming in late because of a change in schedule at her child's day care. He solved the problem by adjusting her hours � and those of the practice � from 8:30 am to 4:30 pm to 9 am to 5 pm, an easy fix. A Halifax group wasn't so lucky. Though the practice had four fulltime employees, one morning the first person to arrive was one of the physicians � at 9:20am only to find the practice still locked and shut.

He laid down the law at a staff meeting that very morning while he was still steaming. Two staffers quit on the spot.

The staff meeting was a good idea; this is often an effective way of getting the message across without singling out an individual. The trick is to keep the tone civil and, above all, constructive. The physician might have begun his remarks something like this: "As you know, Dr Evans arrived this morning at 9:20 and found the office hadn't been opened up yet. I know that you share opening up duties and that's great, it gives each of you some flexibility. The problem is that when we open late and miss patients and phone calls it affects all of us. Patients are our bread and butter and when we let them down we all lose. You're the backbone of this practice. The doctors can't always be here at opening time � they're often seeing patients or at the hospital. That's why it's essential that the office open when we say it will. I know you all understand that. Let's make sure there's always someone here when the patients expect it."

That should be sufficient to end the problem in the short run but staffers should be reminded from time to time, in this case, that the practice must always be opened on schedule. The ultimate solution in a practice with more than a dozen employees: install a punch clock. Don't try it if yours is a smaller office, it will only breed discontent.

RESENTFUL EMPLOYEES
Resentment can most commonly be traced back to the fact that an employee feels overworked relative to other workers and/or is being treated unfairly. Here the best approach is to ferret out the cause of frustration and fix it.

A Sherbrooke, QC, practitioner with two employees discovered that one of them did everything she could to avoid taking telephone messages off the answering machine. The second, a most conscientious young woman, was understandably peeved that she was forever stuck with the responsibility. The solution: duties were reassigned so that one staffer did all the telephone work and the other did all the filing.

In larger practices when you sense resentment, ask the person involved what you can do to make them feel less resentful. You'll be surprised at how forthcoming most are. Often they've come up with a solution on their own. There are some exceptions, however; sometimes you'll find that employees are resentful without cause, or at least without a cause you can live with. You may find, for example, the provincial and/or third party billing isn't kept up to date and that files are often mislaid or plain missing. When confronted, the employee claims that there's too much to do. Perhaps there is, but it could simply be that the work is being done too slowly. There's a huge range in the speed at which individuals work. The solution to this one might be to hire temporary help to get things back on track and see how efficiently the temp worker does the job. You may find that it's time to replace or retrain the fulltime employee. If you decide to let them go, make sure you've adequately covered yourself against a wrongful dismissal suit. (See "Cover yourself" below.)

OVERBEARING SUPERVISORS
As a boss, what you don't know can hurt you. An office manager may be sweet and light when dealing with you and the devil incarnate when directing the staff. Make sure you know how employees feel about working for the practice by regular reviews and by keeping in touch with them in less formal ways. If office morale seems poor, start looking for the cause among the most senior staff first.

COVER YOURSELF
You can't please all of the people all of the time � and you shouldn't try. If an employee won't straighten out after several warnings, let them go � but only do that if you've carefully documented their transgressions. You could find yourself hauled into labour court, charged with wrongful dismissal. Without a paper trail you could come away with a lighter wallet and a heavier heart.