Berning & Affiliates

Should A CEO Doctor Play Jokes On Staff?

One of my clients asked this question in light of the protracted and costly case, Woo vs. Fireman's Fund. The case was recently decided. Dr. Woo, an oral surgeon, decided to temporarily place in an assistant of his, Tina Alberts, fake boar tusks and then photograph her while she was under anesthesia in his chair. She brought suit against Dr. Woo, based on malpractice and invasion of privacy. Dr. Woo wanted his malpractice carrier, Fireman's Fund, to defend. They declined indicating that they had no duty to do so, because the dentist's conduct was outside the normal scope of dental practice. A a state appellate court and four supreme court judges agreed. But, on July 27th a majority of the Supreme Court of Washington sitting En Banc decided in Dr. Woo's favor. The Court reasoned that because Dr. Woo's conduct was "conceivably" within the realm of dental care, the insurer had a duty and should have covered him under his professional liability policy. The Court reinstated a $750,000 jury award to Dr. Woo, which also included a $250,000 settlement he paid the assistant. My response to my client was that, "No CEO in a health care setting should play a practical joke on any person, patient or staff, when that person is under anesthesia." Further, in today's more circumspect practice environments with staff of different ethnic backgrounds, ages and perspectives on appropriate vs. inappropriate behavior, great care should be taken before any joke should be played on staff. See Robert C. Woo, DDS, and Anne M. Woo vs. Fireman's Fund Insurance, NO. 77684-9, July 26, 2007. Read also David Ammons, Associated Press story July 27, 2007, 10:39AM

Take Note NEW FTC Identity Theft Web Site

Doctors and their staff work with a host of personal identify information. Now there is a new web site designed for consumers and business to be alert and learn about identity theft. Here is what the home page states, in part: "This web site is a one-stop national resource to learn about the crime of identity theft. It provides detailed information to help you deter, detect, and defend against identity theft. On this site, consumers can learn how to avoid identity theft – and learn what to do if their identity is stolen. Businesses can learn how to help their customers deal with identity theft, as well as how to prevent problems in the first place. " Go to http://www.ftc.gov/bcp/edu/microsites/idtheft/

This site can act as an information resource you can pass on to your patients. Consider using the site as a staff meeting discussion starter.

Toyota University Teaches Important Lesson

For any CEO focusing on building a team environment around a central mission Toyota has an important lesson. I don't know how many of you caught the news that Toyota is opening its University of Toyota doors to a diverse group of companies. The central lesson, how to have your team in your business implement continuous improvement. This is the core aspect that has lead Toyota to being a top level thoroughly efficient and profitable company. I believe a bias toward improvement in care and the practice is the innate drive of most doctor CEO's but the practice environment often does not facilitate the quest. Toyota provides a valuable lesson in my view about how to keep the focus on continuous improvement front and center as the mission to help drive an organization forward.

Something New

Its no secret that great leaders help to foster innovation in their organization. Doctor CEO's as leaders of their practices can reap substantial benefits when they express interest and encourage their staff to help them develop an innovative and progressive practice. My observation on this point is drawn because of two sharply different practice visits during this week. One is what I will call a "mechanical marvel" of doing what they do well and have done so virtually without change for 15 years. Although running smoothly there are points of friction and neither the doctors or the staff express much enthusiasm. The other practice I will call "energy plus" is bursting with staff attention to detail and performance. Staff self initiates "we need to meet" mini-meetings during the week as needed if there is something that one or more staff members feels can be improved or streamlined. A short informative email is sent the doctor CEO proposing any modification. The policy is that unless he is on a trip there will be an answer (more information needed or request for review) or a decision yes or no in 1 working day. Positive responses to the email and "great thinking" is part of this going and growing practice environment. What's your practice feel? Is it on automatic, even though some things need attention? Or is it a dynamic and participatory practice with staff helping you to lead the practice forward? The choice is yours!

Jerking the Bottom Line

There is a favorite slide that I use in many of my presentations, it says "No Mavericks". What I discuss is that when you have set policies and procedures in a practice it is most disruptive when one doctor or one staff person every so often just hauls off and does not follow the policy or changes it unilaterally. Now there is some further perspective that such people adversely financially impact the practice or company they are employed by. In February’s INC. Magazine a discussion of the financial consequences of having "jerks" is wonderfully illustrated with Stanford Professor Robert Sutton using a Silicon Valley company to show the costs of having to work with such a person with everything from dealing their need for attention, to dealing with their complaints and much more! Beware "jerks" in all levels of your practice (staff, associates and partners) by very carefully interviewing and checking all references.

CEO’s Act To Inspire Their Teams!

Dr. John DeLorme, a client with a large and sophisticated pediatric dental practice in Mission Viejo reported on the success of his annual practice retreat. It was great to hear about the decisions he made leading up to a very positive meeting for the doctors and staff. First, he said he picked a great location, the Laguna Beach Surf & Sand Hotel. Everyone enjoyed the atmosphere and being in a great spot with wonderful views of the ocean! Second, he had planned an important recognition of each staff member and the years they had been with the practice, and gave each a pin with the years prominently showing. Staff received the pins with pride. Third, in the course of the day he asked staff to respond to three exercises, among other activities. Two are ones we have suggested here in the blog. You can read about them at "Tap Staff For Productive Ideas" and "Avoid Being Brand X" . But he also added a powerful one of his own. He asked each staff person to think about and write a note about the one thing they could change in their own performance in the practice that would help the practice advance the most in the next year. Toward the end of the day, each staff member stood up, and related what they were going to work on and why it would help the practice. It was a very emotional and wonderful bonding for this special staff and the doctors. Well done John! I encourage CEO doctors to reach out to your staff and inspire them with your approach or apply John’s or the ones mentioned from time to time here. They will thank you for it and your practice and patients will be better for it!

The CEO’s Expectations

If your staff doesn’t know what you expect they can’t deliver, no matter how hard they try. Over the past year, as we have formed practice relationships and worked to implement practice objectives to grow practices, our interviews with staff raised a troubling question. Namely, they thought they were performing all right for the current doctor but what would be expected with the addition of the new doctor, or the new location, or growth to a multi-discipline practice? In many practices, it seems, there is precious little formal orientation to the expectations of the CEO. It is critically important in my view to not only set clear expectations, but to explain them both for the staff as a whole and as individuals in their respective positions. Try this: ask your staff members to write you an answer to this question: "What is your understanding of my expectations 1) for you, 2) for you in your staff position and 3) as part of the staff of this practice?" If you are not receiving clear answers that hit close to what you thought should be their answers, take action and set a meeting with each staff member to discuss their answers and help them form a clear understanding of your expectations.