Managing Your Practice

A Great Boss


Visitors to my office often ask about the secret to maintaining "such a marvelous" 11-person staff. "You must pay them a fortune," they say.

Yes, they are compensated fairly; but that’s not why they stay. I know for a fact that many of them have turned down higher salaries at big clinics. Staff turnover is essentially nonexistent. (My most junior employee is going on 18 years.)

They remain, I believe, because I welcome their ideas; and I let them know on a regular basis that I notice and appreciate their efforts.

Soliciting employee input is a win-win; it builds loyalty and a sense of community, and you discover better ways to run your office.

I fancy myself an innovative guy, but I can’t think of everything myself. I don’t sit at the reception window; I don’t handle the phones; I don’t put patients in rooms. So, don’t let your staff keep good ideas to themselves. Your staff will only make the effort, however, if they understand that there is something in it for them, other than a token salary raise at year’s end.

The monthly office meeting is a great vehicle for brainstorming. I like my office manager to run them; or more precisely, we like to let them run themselves. We just moderate the discussion, identify problems, and solicit solutions. Usually the answer will come from the dialogue. In addition, we always leave time for airing of any proposals for general improvement of the office as a whole.

By encouraging my employees to propose solutions and suggest better methods and procedures, I demonstrate to them that they have a stake in the success of the office. And when a solution or a new suggestion is staff conceived, the staff has a stake in ensuring that it is implemented and that it works. This method also offers the opportunity to identify and work out minor problems before they become major ones.

Even in this digital age, an essential tool for me at office meetings is a good old-fashioned yellow legal pad, on which I note everything discussed. Each problem identified and each new idea offered is paired with proposed solutions and practical suggestions for implementation, and someone is assigned the responsibility of taking action. Not only does it guarantee that a problem will not continue and a good idea will not die, it also reassures staff that they are not just whistling in the dark when they point out a problem or propose a new office policy.

Some physicians hold meetings away from the office, perhaps at a local restaurant, going on the theory that staff will be more frank when outside of the office. Personally, I have never found my employees reluctant to express themselves in any setting, but if you have, consider that alternative.

Anytime someone comes up with a great idea, or calls attention to a significant issue, I make sure that the person hears – immediately and publicly – the praise that he or she deserves. That goes for all aspects of the office. Whenever I "catch someone doing something right," I note it, and praise that person.

Of course, it is also sometimes necessary to dole out constructive criticism; but as public as praise should be, criticism should be private. And the manner of the criticism is just as important as the setting. I prefer to point out the problem, ask what might have precipitated it, and suggest ways to correct it. After all, nobody is perfect. When you are understanding of your employees’ mistakes, they will be more understanding of yours.

The emphasis, however, is always on praise. When I leave at the end of the day I always thank the staff. If I can’t think of a specific thing to thank them for, I thank them for a good day. Employees thrive on praise, and will go out of their way to earn it.

Dr. Eastern practices dermatology and dermatologic surgery in Belleville, N.J. To respond to this column, email Dr. Eastern at

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