How to manage without micromanaging

A column answering your questions about the business side of your practice

By Karen S. Schechter amednews correspondent— Posted March 24, 2008.

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Question: I am a solo physician in a busy family medicine practice. My office manager is complaining that I am micromanaging the office, that this affects staff morale, and that I should leave the management to her and just practice medicine. My opinion is that it is my practice and I should be able to do what I want. What are your thoughts on this disagreement?

Answer: This is a common interaction between physicians and their office managers, and there is no definitive way to resolve this type of conflict without knowing all of the facts.

Yes, if you own the practice, you should have a say in how it is run. But your level of involvement is at the heart of this issue.

The first question physicians in your situation should ask is why they feel the need to be so involved in the day-to-day management of the office. Is it because they do not have confidence in the office manager? Or does the physician have a need to be in control? Or is it a combination of both?

There could be several reasons for a doctor lacking confidence in an office manager's abilities, including but not limited to poor financial performance, lack of trust, frequent staff turnover and low morale. Or it could be that their respective personalities are different enough to make it difficult for them to work together.

Then there are some people who just need to be in complete control. Our consultants are not psychologists or therapists and are in no position to discuss the possible reasons for this personality trait. But we have observed the impact of bosses like this, including decreased productivity (and revenues), staff members feeling unworthy, decreased staff morale and a situation where the physician feels like, and probably is, working 24/7 just to keep up.

Symptoms of a micromanager

Is the office manager's accusation of micromanagement accurate? The management advisory firm MindTools lists the following as signs of a micromanager:

  • Resists delegating.
  • Becomes immersed in overseeing the projects of others.
  • Starts by correcting tiny details instead of looking at the big picture.
  • Takes back delegated work before it is finished if he or she finds a mistake in it.
  • Discourages others from making decisions without consultation.

If you answer "yes" to one or more of these signs, then perhaps you are micromanaging your staff.

Either situation (lack of confidence or need for control) may be addressed with open communication between the parties involved. If it's a lack of confidence, you should identify why you lack confidence in the office manager, then talk directly with her or him.

Is it something that would require the manager to obtain additional training in finance, accounts receivable management and/or human resources? Often an office manager is a previous staff member who has moved up the ranks and shown exceptional capabilities to accomplish tasks and work with others.

More often than not, however, the office manager may never have received formal training in the areas for which he or she is now responsible. The manager may feel insecure in some areas of responsibility but be afraid to discuss it for fear of showing a weakness.

Another possibility is that the office manager is not clear on responsibilities and level of authority in the practice. Often it is assumed that someone in that position should know his or her duties. But every practice is different, and nothing should be assumed. Having open and frank discussions can minimize this feeling and lead to improved performance.

If you are a micromanager, try to change by finding ways to extricate yourself from the details. Take it one area at a time.

For example, if you are in the habit of overseeing the front desk activities, ask yourself the reason. Then take the problem (if there is one) to your office manager. Discuss your concern and ask him or her to prepare a plan to address it. Once the plan is completed, review it and then provide the manager with the opportunity to execute it -- without your involvement.

Include steps to monitor and report on the plan's outcomes. When you're comfortable that this approach is working, choose another area where you are overly involved. Eventually you may no longer need a formal plan, but the open communication and discussion should remain.

By doing this, you will have more time to look at the big picture and become more involved in the strategic decisions of the practice.

Of course, this does not mean the office manager should not keep you informed of the practice's financial and operational situation. But rather than you having to obtain the details on your own, he or she will be able to present key practice management indicators to you in a way that allows you to relate that information to the practice's overall strategic plan.

Finally, another benefit of letting loose of the details is that it frees up time to see more patients and to enjoy your family, personal interests and hobbies.

Karen S. Schechter amednews correspondent—

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