Dr. Peter Weinstein owns PAW Consulting and is the former executive director of the Southern California Veterinary Medical Association and the former chair of the American Veterinary Medical Association’s Veterinary Economics Strategy Committee. He teaches a business and finance course at the Western University of Health Sciences College of Veterinary Medicine.Read Articles Written by Peter Weinstein
Twenty years ago, the KPMG megastudy on veterinary medicine noted: “The majority of animal care is still being delivered through a highly fragmented and inefficient system. This includes issues related to excess capacity, staff utilization and the use of capital resources.” The report went on to say, “There is some evidence that practices that utilize technicians and assistants are more financially better off than those who are less reliant on staff labor.”
So, as we all know, the delegation of responsibilities to appropriately trained paraprofessional staff is a good business decision.
We have seen the glass ceiling that is reached in a practice when the veterinarian tries to be everything to everybody. There are only so many hours in the day. If you want to grow your practice to the next level, if you want to see more patients and make more money, you must learn to empower and utilize the well-trained paraprofessionals you hired.
We, as a profession, are not far removed from the “good old days” of the ambulatory practitioner going out on his own and doing everything by himself. We are, however, in a new era — one with different expectations and higher standards. It’s time to stop living in the past.
WONJI: Work On Not Just In
Working on the business is the primary role of the entrepreneur. Working in the business is doing task work that can be delegated. Are the tasks that you do activities that others can do?
What are those things that only you can do or must do because of regulations? What are you best at? What are your special talents? What makes you brilliant? These are your passions and where your energies should be directed.
“Delegation” comes from Latin — “de” for “away” and “legare” for “to send.” Thus, to send away or dispatch. On the other hand, “veterinarian” comes from the Greek: “to keep everything to themselves.”
The ability to delegate starts with having the right people. So hire correctly. Delegate those things not in your wheelhouse, those things that allow you to be the rainmaker you are expected to be. Work less on those things you are not that good at (they take longer) or are not passionate about (you’re less motivated and thus they take longer).
Go Ahead and Get Started
Here’s what you need to do.
1. Identify all the tasks or things that you do over a month or so. This will differ based on your role within the practice. Use your calendar or a spreadsheet to track everything. Are you able to do all those tasks in your defined workweek, are you late getting home or do you take work home with you?
2. Assign one of the following grades to each of the tasks you identified in step one:
A: Must do it
B: Not a must but I love to do it
C: Like to do it
D: Don’t like doing it
F: Should never do it
3. Now, determine what you can delegate. In reality, anything not an “A” can be delegated. Choose one or more tasks a week that you will delegate. Start with tasks that take time and prevent you from performing the tasks of greatest value. Remember, your greatest value as a veterinarian is patient and client care.
Limited space prevents me from listing all the tasks I routinely see veterinarians do because they don’t trust anybody else to do the work.
4. Identify to whom (either a person or a job description) you can delegate said tasks. Certain members of your team have skill sets that should be utilized. Certain members of your team are eager to grow, contribute and become involved. Certain members of your team want to make more money. Identify those go-getters. Hopefully, everybody on your team is one.
Think about which tasks fit the manager’s role, technician’s role, veterinary assistant’s role and client service person’s role. Ultimately, those tasks should be added to their job descriptions and memorialized as an expectation of employment.
5. Create the needed system and processes for the task. Most tasks have a specific way of getting done in your practice. However, from putting in a catheter to ordering office supplies, a more effective and efficient process might be found when a task is delegated.
Create a template or a form to document the tasks you are delegating. The form will be updated if the process changes. The outcome never changes, but the process to get there might.
For each task you intend to delegate, you need to define a preferred outcome. For catheters, it might be placing a catheter correctly the first time. For ordering office supplies, it will be the frequency, the location and how much. For the bank deposit, it will be getting every dollar that leaves the hospital into the bank. For hiring staff members, it might be identifying those who fit the practice style and philosophy and have an appropriate work ethic.
6. Train to trust. To quote Henry Ford, “The only thing worse than training your employees and having them leave is not training them and having them stay.”
With the tasks and people identified and the processes delineated, it’s time to train people to a level of competency and, subsequently, trust. But first, I’d like to emphasize something: DELEGATION WITHOUT TRAINING IS AN UNMITIGATED FAILURE WAITING FOR A PLACE TO HAPPEN!
The time spent training and perfecting will give the delegator the peace of mind that the delegatee is ready to perform the task correctly each time.
What is the level of competency that is expected for you to trust someone to perform a technique without supervision? In veterinary school, we used the adage “See one, do one, teach one.” It shouldn’t be much different here. You must define the level of competency. Monitor or test delegatees to ensure that they reach that level and then leave them alone.
7. Release, but keep the person accountable. Daily, weekly and monthly check-ins should be conducted to see how well your team is doing. This is not micromanaging, it’s “How are things going?” managing. Other team members or unexpected outcomes will alert you soon enough that tasks are being done appropriately. Trust me, if something goes wrong, you’ll know. Remember to celebrate when things are going right.
8. Keep track of what was delegated and add it to the job description for permanency. You don’t want to lose track of the tasks you delegated, and you don’t want to lose sleep over them, either. Once a task has been delegated, add it to the job description of the team member performing said task. This way the next person promoted to or hired for the position will have the responsibility of performing. You don’t want the task back in your lap because someone left.
9. Don’t look back. It’s very easy to want to keep your finger on the pulse of the tasks you delegated. Don’t! Don’t abdicate, either. Keep team members looped in and make them accountable to the practice, the leadership and each other. Accountability is paramount for successful delegation. With a team that understands accountability, you can focus on the next task to delegate.
Give frontline people the ability and authority to solve problems. “I have to check with my manager” is not a confidence builder with clients. Authorize your well-trained, well-chosen, accountable team to make decisions in the best interest of the client, patient and practice. A bank that I read about gave tellers the authority to say “yes” to just about anything, but if they thought of saying “no” to a customer request, they had to find somebody else (their supervisor) to say “no” as well.
Empower your team to take well-educated chances, and reward them for taking those chances. If you don’t have to be stopped 100 times a day to get permission to buy more toilet paper, think about how much time you’d save.
Years ago, leadership meant power. Today, the key to leadership is helping others to succeed. Leaders are being taught that the best way to do this is by letting go.
OK, you have accepted the need to delegate. You have identified what you are willing to delegate. You have trained to a level of competency and trust. Now, it’s time to see what happens. If everything works perfectly, you have delegated something that previously took up your time but wasn’t being paid at a doctor’s salary. On the other hand, if things don’t go perfectly, do a little coaching and counseling and let them have a go at it again.
The limiting factor in a practice’s success is the amount of time the doctor can spend with the client and patient. If a doctor doesn’t spend his time only doing the big three — surgery, prescribing and diagnosing — he is losing money. If a doctor spends time doing non-doctor responsibilities, he is disrespecting the skills and desires of his team. If a doctor is taking blood samples, setting up fecals and running month-end reports, how can she be in an exam room diagnosing or prescribing? If doctors are putting in catheters, changing fluid sets, cleaning teeth, trimming toenails and expressing anal glands, how much should they be paid per hour?
To delegate, you need to identify what you want to release, train to a level of trust and then step back and watch the staff flourish. If you do this, your practice will flourish and you can focus on quality medicine. Your patients will benefit, your clients will benefit, and your staff and practice will benefit. And, most importantly, you will benefit.
To misquote Bob Dylan, you shall be released.