Ophthalmology Business

DEC 2013

Ophthalmology Business is focused on business topics relevant to the entrepreneurial ophthalmologist. It offers editorial, opinion, and practical tips for physicians running an ophthalmic practice. It is a companion publication of EyeWorld.

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continued from page 14 illegal or is violating a clearly stated policy of harassment. Managers need to know the details like what exactly harassment, fraud, and inappropriate behavior mean. They could have a lawsuit on their hands if they treat the problem one way when they should've treated it a different way, Mr. Riordan said. Managers should also proactively build strong relationships with human resource personnel who will be an invaluable resource when problems arise. Broadly speaking, managers can approach problem employees through three progressive levels, Mr. Riordan said. They are classified as preventative action, informal discipline, and formal discipline. The idea is to be doing the preventative work that keeps someone from becoming a problem employee and nurturing that person when he/she shows any signs of difficulty, he explained. "In other words, you don't want to wait until someone is sick to start running a health program. You've got to be proactive, you've got to put things in place, you've got to do regular training, coaching, and mentoring so that you can maintain the health of the organization and the individuals," Mr. Riordan said. Following preventative action, the next level is the informal approach, he said. This would mean moving from things like coaching, training, mentoring, and positive input, to informal discipline, which includes verbal counseling and then written counseling. The approach is stepwise, he said. Verbal counseling is less severe, and that can be anything from a gentle talk to a serious conversation. Managers should also make sure to document the verbal counseling, Mr. Riordan said. Take note of the date and time of the conversation as 16 well as the points that were discussed. If there is no change of behavior, the next step may be written counseling, he said. "It's not a formal letter of reprimand yet, but it is in writing that there are some serious issues to be addressed," he said. If informal discipline does not work, the next level up is formal discipline, and that's a letter of reprimand, any kind of reduction in pay, suspension, or termination. These all occur in escalating levels. Managers should be aware of competency issues as well, like safety concerns and technical competence. "You may have a wonderful employee but if he or she keeps violating safety guidelines then that's a problem," he said. Approaching the employee can be difficult, especially for managers who do not like confrontation. Mr. Riordan recommended two helpful tools that can prepare managers for that uncomfortable conversation. One of the tools is called Crucial Conversations, which is a popular model. "It is a model that helps develop a stepwise approach to a discussion starting with how do I engage this person? Is it an informal or formal conversation? Do I pop into their office, ask them to come to my office, or take them for a cup of coffee? It's all about timing, the setting, and privacy—that's critical," he said. The approach also helps managers consider what's the right conversation to have, what their intent going into the conversation is, what are the facts involved versus feelings, and what are the emotions. It helps them catalogue what exactly needs to happen so that they can prepare to have the right conversation depending on how serious it has to be. Ophthalmology Business • December 2013 The second model Mr. Riordan likes to use is called SBID from the Center for Creative Leadership, which stands for Situation, Behavior, Impact, and Desired Outcome. It helps set the context for determining the situation at hand, what behavior to focus on, what's the impact of that behavior that needs to be addressed, and what's the desired outcome. It could be that a certain behavior should not be repeated or that there be an improvement in a certain area. It's a formula that helps managers be better prepared to move into the discussion. One of the key issues Mr. Riordan addressed was the difference between formal and informal action. If it's a serious situation, then a manager should bring in someone from human resources or another manager, a doctor, or owner as a witness to the conversation. Depending on how serious the situation is, management needs to treat it accordingly. Mr. Riordan reiterated that managers should address a problem at the level that the issue merits. "You don't need surgery for a bothersome paper cut, but conversely you don't want to give someone an aspirin when it's actually a cancer situation. Good-natured people will often underestimate the potential seriousness of a situation," he said. Some people don't want to make a big deal of it, but once managers see the first signs of a problem, they should treat it so it doesn't get worse, he said. OB Editors' note: Mr. Riordan has no financial interests related to this article. Contact information Riordan: 703-470-7441, john@cindyzook.com

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