A practice manager shouldn’t be an absent employee’s automatic replacement. Cross-train team members and empower them to look after each other.
As the young manager of a small veterinary practice, I regularly spent part of my workweek covering shifts for vacationing or sick veterinary technicians and client service representatives. As the animal hospital grew alongside my confidence and status, I pitched in only occasionally as a courtesy and not under compulsion or out of desperation.
When and how often should practice managers fill in for employees? Who’s first on deck when appointments start to fall behind, a vacation week needs coverage, someone falls ill or an employee quits before a replacement is hired or trained? At what point does a manager’s backup role detract from the business?
Veterinary managers are fixers and, to some extent, pleasers. Assigning a shift to someone who does not want it or leaving the team short-handed when you know you could work a shift can be difficult. But picking up someone else’s shift also means allowing the paper pile on your desk to sit, tabling an exciting project or delaying your personal life yet another day. As the adage goes, working on your practice is difficult when you perpetually work in your practice.
On the flip side, stepping in can exemplify what a team player looks like, mitigate staff burnout and provide valuable firsthand experience. In practices with only one or two full-time doctors, managers might frequently work on the floor to avoid the combined expense of someone’s paid time off and a replacement employee’s hourly wages.
Determining the cost-to-benefit ratio is the most advantageous solution to the dilemma. What is being given up if you fill in, and is the tradeoff sensible? If the answer is a negative net present value, use your management skills to find sustainable alternatives instead of becoming the solution yourself. Here are six strategies.
Hire With Scheduling in Mind
For many reasons — ease of scheduling being one — my hospital tries to hire employees who are financially stable at working 30 to 35 hours a week and who can pick up additional hours when needed. This approach puts pressure on the human resources budget as it requires me to pay full-time benefits to 15% to 25% more employees. Still, the option has paid dividends at my practice by providing schedule flexibility, more quality time off for employees and a steady, reliable, long-term workforce.
In employment advertisements and during job interviews, I am candid about weekly wage expectations and ask candidates to seriously consider their budget before they accept my offer. I often say, “We only want people to work for us who can afford to do so.” If they need 40 hours a week plus overtime to be financially comfortable, they are better off interviewing elsewhere, even if we occasionally lose a skilled candidate.
Keep the Schedule Fluid
Employees value the predictability of fixed schedules so that personal appointments and commitments can be made in advance. I find that asking them to adjust their schedules once days off have been set can be difficult. My compromise is to develop a new schedule every three to six months based on team members’ ever-changing desires, adjusting it for time-off requests and publishing it a month in advance whenever possible. This creates a standard of flexibility.
During onboarding, new hires are told that they are expected to cover co-worker shifts as often as they request time off, especially when their allotted paid time off has been exceeded. A rule of thumb at my practice is that time-off requests should be submitted before the schedule is published. Employees who make late requests are responsible for finding their replacements.
Create a Culture and Cross-Train
When shift coverage is needed, team members should support one another and feel confident that no one is gaming the system. The hospital culture should both encourage employees to take time off only when it is truly needed and persuade teammates to happily cover for a co-worker or swap shifts. Similarly, teammates are expected to watch for someone falling behind on the job and offer to help.
One way this becomes more logistically possible is by cross-training the team. Many of our receptionists are also veterinary assistants. Some of our assistants have the skill set to handle technician appointments. Our licensed veterinary technicians sometimes are scheduled as assistants. Everyone in the building is expected to be able to answer the phone and book an appointment. Additionally, several team members get off-the-floor office hours ranging from five hours a month to 10 hours a week so that they can complete assigned administrative tasks. The office hours can be rescheduled to keep the floor fully staffed.
Don’t Be the Best Option
Dressing in business attire helps me garner the respect I need to be an effective manager. A side benefit is a team member pauses before asking for my help in a pinch. Laying on the floor, restraining a patient, being scratched by nails, or becoming covered in fur, slobber, urine, blood or anal gland secretions while wearing dress slacks and a blouse just doesn’t fit.
I once had strong assistant skills, but they have waned over the years, making me a suboptimal choice during patient care. Similarly, if I am asked to help in reception, I bring office work with me and allow the rest of the team to take the lead on phone calls and routine work. I act as a backup only.
While I don’t set out to be an unhelpful substitute, I do not strive to be the ace-in-the-hole star replacement. When looking for shift coverage, I expect the team to exhaust all other options before asking whether I am available. When it comes to that, I am happy to oblige, knowing that my schedule is not being hijacked unnecessarily.
Practice Operating Lean
Pandemic staffing and fully booked schedules have the potential to leave hospitals short-staffed. This is an ideal time to look closely at your hospital’s inefficient systems and low-priority tasks. Where can automation reduce the manpower need? What processes vary widely depending on the team member and which ones are best-practice models? Where are the bottlenecks and how can they be widened? Focusing on daily flow creates a well-oiled machine that operates consistently even with minimal staffing.
Manage Your Way Out
While working the floor sometimes might feel like the honorable path for a practice manager, I argue that it is more likely the product of mismanagement. Instead of giving up office time to fill in for a team member, use the time to strategize successful recruiting, reliable scheduling, strong team building and efficient operations.
Take Charge columnist Abby Suiter is the practice manager at Daniel Island Animal Hospital in Charleston, South Carolina. She has spent nearly her entire life in the industry, earning her keep in her parent’s animal clinic before advancing into the world of veterinary management. She holds undergraduate and graduate degrees in business and is a certified veterinary practice manager.
Train your team leads to see staffing solutions that do not involve management. Walk them through how to view the workweek as a whole and how to swap shifts to meet the practice’s needs without draining resources.