Managing staff during their personal crises requires care, communication
Sick children, marital problems, financial strains – all are stressful personal crises that can happen to any of us and those we work with every day. When these things happen to staff, it directly affects their ability to perform their jobs – and that can affect patient care. Your staff may look to you for help during trying times; but some may not. So how do you know when staff needs your help? What effect can a staff member's personal crisis have on patient care? And are you prepared for this inevitable occurrence?
Effects of personal crises on a medical practice
You may be the last person in the practice to hear about staff crises. That can be good and bad: good because you don't need or want to know all the personal issues that occur, but bad because some of the big things (marital problems, issues with children, financial issues) will negatively affect a staff member's ability to do his or her job well.
This can jeopardize the standard of care a patient receives, diminish the effectiveness of your practice and, in the worst case, cause you to lose patients. So how do you find out what's happening before it's too late? It's simple: Communicate often in a meaningful way with your staff. This is how to maintain relationships and preserve open and honest channels of communication.
Chances are good that your staff doesn't want to appear weak, or they don't want to burden you with their problems. Therefore, the tendency is to keep those problems under wraps. This places utmost importance on staff hearing - from you - that they can come to you in times of need. And if not you, then someone else in an authority or supervisory position whom staff knows can speak for you.
Indirect ways to uncover your staff's personal crises
One method of determining staff crises is by closely following their performance, which will require heightened diligence on your part.
A performance measurement can be accomplished by consulting the metrics generated by your practice - a personal crisis very often can be detected by watching the number of inquiries that progress from phone call to consult to scheduling. If you see a dip in these areas, you might have a staff member with a personal problem. This isn't 100 percent specific or sensitive, but it can be a helpful and indirect indicator of a personal crisis affecting on-the-job performance.
Another indirect method is to monitor the feedback you get from your patients. If you notice that one particular employee is being singled out - one who may never have been reported as a problem before - a personal issue could be at the core.
Crisis detected - now what?
Once you've identified the problem, realize that this staff member needs your support. They also need to know that you're monitoring their performance as well as the specific areas of their job that have been affected.
Sometimes there is a tendency to not confront a staff member, particularly during a crisis - this would be a mistake. Confronting the issue and the staff member sends the message that you care about your practice and you care about your staff. Failing to do so can send the opposite message.
You also must be willing to be flexible in offering time off, professional counseling and the general support needed for the given situation. Time off may be a couple days, or it might be a week or more; regardless, your staff will greatly appreciate the gesture - and when the crisis is over, they'll be even more supportive and committed to you and your practice.
In addition, the U.S. Department of Labor's Family and Medical Leave Act entitles eligible employees of covered employers to take 12 work weeks in a 12-month period of unpaid, job-protected leave for specified family and medical reasons, with continuation of group health insurance coverage under the same terms and conditions as if the employee had not taken leave.
Remember, too, that you're more likely to be better-connected in the health care world than your staff member - making it easier for you to find an appropriate professional referral if necessary. Your direct guidance and involvement will provide a sense of security.
Three strikes and you're out
So when is enough enough? How often are you obliged to put your practice in jeopardy for a member of your staff who's having personal problems severe enough to spill over into their work? This can be a sensitive issue - and in the end, each case is different.
As a general guideline, if the problem persists despite time off, counseling and other measures, a "three strikes and you're out" approach is a good place to start. This is fair to you, your practice, your patients and your staff. Keep in mind that the other staff members are usually aware of what's going on, so making the hard decision (letting someone go) maintains the integrity of the office. Keeping an employee who cannot keep up with their responsibilities will generate resentment among the others left to pick up the slack - and possibly complacency. The worst-case scenario is that your overall leadership will be called into question.
What counts as a "strike" and what amounts to "no harm, no foul" is something that you have to determine. But you must be firm, fair - and whatever method you employ must be applied to everyone.
Personal crises among your staff can be insidious, so it's important to have direct and indirect methods to detect problems before your practice suffers.
Farzad Nahai, MD, Atlanta, can be reached via e-mail at drnahai@gmail.com.
Visit the YPS Forum on the ASPS website.
Advertisement
