In our work helping medical practices improve their profitability and efficiency, it’s not uncommon to find that employee morale, performance, and turnover are problems.  Those problems, in turn, often stem from the relationships between staff and their leaders — and staff perceptions about how physician owners and practice administrators regard them.

Sometimes, there’s a bit of a chicken-and-egg problem: are leaders coming down hard on employees because employees are under-performing?  Or are employees under-performing because they’re stressed and discouraged by standards they can’t meet, delivered emotionally by demanding bosses?

In some ways, it doesn’t really matter how leaders address unexpected shortfalls.  Good performers are typically hard on themselves already.  They know when they’ve messed up.  Often, what they really need is permission to regroup and fix the problem — and to know that you trust them to do a good job.  Getting angry usually doesn’t help — it’s usually counter-productive.

This is the point of this excellent post on Harvard Business Review well worth a read (you can access up to five HBR articles for free, and a few more if you register).

To the article’s great points, I would add that it’s also important to determine if a structural problem inside the organization made it hard for employees to do what was asked.  In a medical practice, for example, are employed providers not meeting productivity goals because they’re unmotivated, because they haven’t made an effort to grow their practices through referrals, or because there are patient flow bottlenecks that make it impossible for them to see more patients?  Is a biller’s accounts receivable growing because she’s not billing fast enough, or because there’s no system to put patients on payment plans ahead of large procedures?  Are voice-mails piling up because the staff charged with answering the phone are juggling too many balls?

Ask a few questions, take a deep breath before reacting to performance problems.  Be sure you understand what’s really behind poor performance before you react emotionally and trigger consequences that will only make a tough situation worse.

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