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Practice Management

Can We Talk?

by Sheila Grosdidier, BS, RVT, MCP
    Doctors talking

    This article is part of a real-life case involving questions of communication, discrimination, and compensation. For the other articles about this case, follow the links below.

    The Story So Far…

    A practice owner, Dr. Non, hired a new male associate, Dr. New, at a starting salary of $85,000. His existing female associate, Dr. Strong, who was making $65,000, found out Dr. New’s salary and confronted Dr. Non, asking for equal pay. Dr. Non refused, stating that her production did not warrant a larger salary and that he had issues with her performance. Dr. Strong filed a discrimination claim with the Equal Employment Opportunity Commission (EEOC) and, when that was denied, a civil suit against the practice for discrimination.

    (For the full background of the case, read “Dr. Non v. Dr. Strong.”)

    Can We Talk?

    Can you imagine the impact something like this would have on your practice? In the ongoing case, employees have been required to testify. I am sure that some employees are supportive of Dr. Non, while others support Dr. Strong. Imagine the effect this has on the morale of the practice. Let’s then figure in the time taken away from the practice to get ready for all these legal proceedings and the proceedings themselves. The effect could be devastating to your practice. Such a situation will affect not only you personally, but also your health care team, your doctors, and your clients.

    So how could Non v. Strong have been avoided? In my opinion, a number of factors caused this situation to escalate to its current point. First and foremost was the lack of communication between Dr. Non and Dr. Strong. I would fault both parties on this, but Dr. Non, being nonconfrontational, thought that not dealing with problems would make them go away. Guess what: they don’t. In management, as in medicine, untreated problems just fester and boil until they blow up! You must communicate with your associates and allow them to communicate with you. Dr. Non should have spoken to Dr. Strong before he hired Dr. New and told her what he was going to do and why. Dr. Strong also had no idea about her performance issues, again because Dr. Non did not want to deal with them. His feeling was that it would be more of a hassle to replace her; she was doing an adequate job, so he was not going to meddle. Also, Dr. Non did not do any kind of performance reviews on his associates, and although the practice did have a practice manager, this person was not empowered to do reviews on the associates either.

    Since there was little communication between Dr. Non and his associates, there was, of course, little to document. There are no employee files on the associate doctors, no notations of requests for time off, no records of performance issues or negative interactions with team members or clients, nothing. Therefore, the validity of the issues surrounding Dr. Strong’s performance is being questioned. There are also legal questions surrounding Dr. Non’s employment contract with Dr. Strong, which, when she was hired, was supposedly automatically renewable.

    So what can we learn from this situation as far as the team is concerned?

    • Communication is always the key. As a practice owner, you have to communicate with your doctors. Don’t think that by not dealing with a problem, you can make it go away—it will only fester and boil up later. You should have monthly meetings where you meet just with your doctors and talk about management issues as well as medical ones.
    • I would also highly suggest that you conduct formal performance reviews with your doctors. We have some great performance review forms at VMC-inc.com, or you can design your own. A sample form is available here. The associate should be asked to fill out the form first, then you fill out the same form on the associate. Then you can both then sit down and review how you rated the various criteria and discuss the differences. If you have a practice manager, he or she should be able to do performance reviews, but you still need to provide your own input.
    • If you are having performance issues with an associate, don’t wait until the end of the year to do a performance review—talk to him or her as soon as possible! The performance review should be a recap of what has already been discussed during the year and how issues have improved (or not).
    • Effective communication doesn’t apply only to your associate veterinarians. Have a full team meeting at least once a month so that technicians, receptionists, and other team members can have a forum to state their problems and concerns. 
    • Communicate positive information, too! Meetings and performance reviews should not be all negative. They should also be opportunities to recognize your employees for all the wonderful things they have done.
    • Lastly, you must have an employment contract with your associate doctors that addresses compensation and performance. This contract needs to be drafted or renewed on an annual basis.

    It is my hope that if you do these things, you will never wind up in Dr. Non’s situation.

    Read about the other aspects of this case!


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